泌尿、男生殖系统肿瘤-11-08 科目讲解.pptx

;泌尿、男生殖系统各部位都可发生肿瘤;概述;肾肿瘤;肾肿瘤;肾癌(renal cell carcinoma);肾癌(renal cell carcinoma，RCC);肾癌;肾癌;肾癌;肾癌;CT 对肾癌的确诊率高，显示肿瘤部位、大小、有无累及邻近器官。 表现为肾实质内不均质的肿块。平扫显示为肾存在实质肿物（图1），增强扫描为 肿物强化超过20HU，提示肾细胞癌（图2、3）。 ;肾癌;肾癌;肾癌;肾母细胞瘤(nephroblastoma);肾母细胞瘤;肾母细胞瘤;肾母细胞瘤;肾母细胞瘤;肾母细胞瘤;肾盂肿瘤(tumor of renal pelvis);肾盂肿瘤;肾盂肿瘤;肾盂肿瘤;膀胱肿瘤(Bladder Cancer);膀胱肿瘤是泌尿系中最常见的肿瘤。 90%为移行细胞癌。 膀胱肿瘤发病率在西方国家的男女约为3:1，但女性死亡率更高。 50岁很少发病，随着年龄的增长发病率逐渐增加。;Aromatic amines;尿路上皮癌/移行细胞癌 Urothelial (Transitional Cell ) Carcinoma 鳞状细胞??? Squamous Cell Carcinoma 腺癌 Adenocarcinoma 其他：Small Cell Carcinoma, Metastatic Adenocarcinoma…;尿路上皮癌 Over 90% of bladder cancers in the United States are urothelial (transitional cell) cancers. Most are papillary well (urothelial tumor of low malignant potential) or moderately (low grade) differentiated cancers.;膀胱肿瘤—分期;膀胱肿瘤—分期;症状Symptoms 血尿Haematuria – most common Intermittent, painless, whole course. 尿频frequent urination 尿急urgency of urination 排尿困难dysuresia 盆腔痛pelvic pain;症状Symptoms 体格检查Physical examination 影像学检查Imaging 尿细胞学检查Urinary cytology 尿分子标志物检查Urinary molecular marker tests 膀胱镜检查Cystoscopy;体格检查Physical examination 盆腔肿块Pelvic mass;影像学检查Imaging Intravenous urography(IVU) - Large exophytic tumours may be seen as filling defects in the bladder. CT urography - used as an alternative to conventional IVU. Ultrasonography - the initial tool to assess the urinary tract. MRI - invasive bladder tumors.;尿细胞学检查Urinary cytology Examination of voided urine or bladder-washing specimens for exfoliated cancer cells has high sensitivity in high-grade tumours but low sensitivity in low-grade tumours. Cytology is useful when a high-grade malignancy or CIS is present. However, urinary cytology often is negative in the presence of low-grade cancer.;膀胱镜检查Cystoscopy The diagnosis of bladder cancer ultimately depends on cystoscopic examination of the bladder and histological evaluation of the resected tissue. The diagnosis of CIS is made by a combination of cystoscopy, urine cytology, and histological ev